The basophil adenomas of the pituitary body and their clinical manifestations (pituitary basophilism)

H Cushing - Journal of Neurosurgery, 1964 - thejns.org
H Cushing
Journal of Neurosurgery, 1964thejns.org
Introduction. In a long since superseded monograph on the pituitary body and its disorders,
published in 191~, a section was devoted to a group of cases which showed peculiar and
sundry polyglandular syndromes. It was stated at the time that the term" polyglandular
syndrome" implied nothing more than that secondary functional alterations occur in the
ductless-gland series whenever the activity of one of the glands becomes primarily affected;
and further, that the term, as employed, was restricted to those cases in which it was difficult …
Introduction. In a long since superseded monograph on the pituitary body and its disorders, published in 191~, a section was devoted to a group of cases which showed peculiar and sundry polyglandular syndromes. It was stated at the time that the term" polyglandular syndrome" implied nothing more than that secondary functional alterations occur in the ductless-gland series whenever the activity of one of the glands becomes primarily affected; and further, that the term, as employed, was restricted to those cases in which it was difficult to tell where the initial fault lay.
That a primary derangement of the pituitary gland, whether occurring spontaneously or experimentally induced, was particularly prone to cause widespread changes in other endocrine organs was appreciated even at that early day, and it was strongly suspected that this centrally placed and well protected structure in all probability represented the master-gland of the endocrine series. The multiglandular hyperplasias of acromegaly, so evident in the thyroid gland and adrenal cortex, were already known, and the no less striking atrophic alterations in these same glands brought about by the counter state of pituitary insufficiency were coming to be equally well recognized. But in spite of these hopeful signs, we were still groping blindly for an explanation of many other disorders, obviously of endocrine origin, like those associated with pineal, parathyroid or suprarenal tumors. Out of this obscurity, those seriously interested in the subject have, step by step, been feeling their way in spite of pitfalls and stumbling blocks innumerable. The usual method of progression has been somewhat as follows. A peculiar clinical syndrome has first been described by someone with a clarity sufficient to make it easily recognizable by others. This syndrome in course of time has been found to be associated either with a destructive lesion or with a tumefaction primarily involving one or an-
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